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Introduction: Work-related ill-health and resulting sickness absence is detrimental to the employees themselves, the employer and the national economy as a whole. To reduce the risk of work on health, information about causal factors and sectors at risk must first be gathered. General practice had been referred to as the ‘blind spot’ in occupational health as so little was known about work-related ill-health seen by GPs. The principal aim of this thesis was to estimate the incidence of work-related ill-health in the UK/GB as determined in general practice, to critically compare general practice reporting with other data sources and to evaluate the incidence and sickness absence burden of work-related ill-health. Methods: Data on incident cases of work-related ill-health and sickness absence were collected from GPs reporting to a UK-wide surveillance scheme (The Health and Occupation Reporting network in General Practice (THOR-GP)), and compared to information from other sources. To enable the calculation of incidence rates, THOR-GP population denominator information was gathered and characterised using Census information based on patient and practice postcode. Results were presented as a series of four peer-reviewed published papers and an additional chapter exploring the calculation of incidence rates.Results: The work-related ill-health diagnoses reported by GPs were mainly musculoskeletal (53%) and mental ill-health (30%). Overall, half the cases were issued with sickness certification. The proportion of cases issued with sickness certification differed by diagnosis; 79% of psychological cases had certified time away from work and these conditions were responsible for the majority of sickness absence days certified (56%) however these cases were rarely referred to secondary care (1%). Industries operating within the public and financial sectors had the highest incidence rates of work-related mental ill-health and correspondingly the highest rates of sickness absence. Industries with the highest proportions of self-employment had the lowest rates of sickness absence. When compared to reports from occupational physicians (OPs), GP information was more representative of the employed population of the UK, whereas OP data concentrated on industries covered by occupational health services. Incidence rates based on clinical specialists’ reports were much smaller than GP rates and biased by severity and referral patterns. Rates based on self-reported (SWI) data were higher than GP rates due to greater inclusivity; however diagnoses were unsubstantiated by medical opinion. The THOR-GP population denominator was characterised using approximately a million patient postcodes (and linking these to Census data) from over a hundred GPs. These population estimates compared well with those based on the practice postcode and enabled the calculation of incidence rates of work-related ill-health for this and (with weighting methods) the GB population. Rates of work-related ill-health were highest for those employed within construction and agriculture.Conclusion: This thesis has shown how the systematic collection of work-related ill-health data from GPs adds to the knowledge base about the distribution and determinants of work-related ill-health (and sickness absence) within the UK/GB workforce. This work also contributes to knowledge relating to the ‘primary care denominator problem’ in calculating rates of incidence from general practice.

Bakgrund: Ensamhetskänslor i den senare delen av livet är ett hot mot det fysiska, psykiska och sociala välbefinnandet med allvarliga konsekvenser, vilket leder till betydande hälsoproblem med konsekvenser för social utestängning, sjuklighet, minskat välbefinnande och dödsrisk. Denna kvalitativa studie genomfördes för att skapa mer förståelse, inblick och erfarenhet hos vårdpersonal angående äldres hälsa som är påverkad av ensamhetskänslor. Syfte: Syftet var att beskriva upplevelser av ensamhet och dess påverkan på hälsan hos äldre personer.                                                       Metod: Kvalitativ litteraturöversikt med induktiv ansats. Studien bygger på tio vetenskapliga artiklar där alla artiklar kvalitetsgranskas, sedan analyserades och sammanställdes för att svara på studiens syfte.                                                            Resultat: Studiens resultat grundar sig i tre olika huvudkategorier och åtta underkategorier. Upplevelse av ensamhet med underkategorierna; Ensamhet till följd av förlust, Ensamhet skapar oro och rädsla, Ensamhet som njutning. Påverkan på hälsan med underkategorierna; Psykiska konsekvenser, Fysiska konsekvenser, Sociala konsekvenser och Sjuksköterskans betydelse med underkategorierna; Främja hälsan, Uppmärksamma ensamhetskänslor.  Slutsats: Studiens resultat påvisade att ensamhetskänslor hos äldre är ett hälsoproblem. Ensamheten kan uppstå av olika faktorer i samband med åldrandet. Äldre personer är extra utsatta och ensamhetskänslor har negativ påverkan på hälsa samt negativa känslor i kroppen. Det är viktigt att vårdpersonal uppmärksamma patienternas tecken på försämrad hälsa, och för informationen vidare så att anpassade insatser kan sättas in.

The maintaining of health and well-being in the academic field of work is a widespread challenge. The increased interest in social capital provides an opportunity for public health coordinators in the academic field to advance their social agendas so that optimal development within the relationship between social capital and health and well-being can be constant that in turn enhance good working environments. This relationship between social capital and health and well-being is embedded in networks of trust which lead to coordination and cooperation in the academic field of work for mutual benefit. Provided by social capital, there is a great opportunity for health coordinators, to flex their theoretical muscles in coming to grips with the social elements of health determinants and health promotions within the academic field of work. To understand the more progressive interpretation of social capital, it calls for the creation of health promoting communities through a process of mutual reinforcement of the social and the economic sector (workplace). This study will distinguish between the micro, meso and macro levels of social capital within health and well-being, within the academic field of work, with the specific linking, bonding and bridging in their specific dimensions. / Thesis (M.A.(Sociology) North-West University, Mafikeng Campus, 2014

Occupational stress is considered to be a rising concern in many organisations in South Africa; it is, moreover, a pervasive problem in our communities in general. The consequences of high-stress environments are typically a, reduction in the quality and quantity of job performance, high levels of absenteeism, an increase in turnover, an increased number of grievances and increased frequency of accidents. Correctional Services has been reported to be the most challenging and frustrating component of the criminal justice system. Factors such as having a high level of responsibility, genuine threats to personal safety, rotating shifts, meager salaries and unpleasant surroundings, all add to the stress of Correctional Service Officials. The results of uncontrolled stress are costly to both the individual and the organisation. It is thus important for both the organisation and employees to learn or acquire ways of coping with stress. The empirical objective of this study was to investigate relationships between occupational stress and i l l health among employees of Correctional Services in the Vereeniging Management Area, in order to contribute towards an understanding of the interaction between these variables, and the implication thereof for the management of occupational stress and i l l health in the specific setting. A cross-sectional design was used to collect data and to attain the research objectives. The study population included the entire population consisting of (n= 197) employees of Correctional Services in the Vereeniging Management area. Management and production levels were fully represented. The Correctional Official Stress Inventory, General Health Questionnaire, Maslach Burnout Inventory and the Utrecht Work Engagement Scale were used as measuring instruments. The reliability and validity of all questionnaires were found to be acceptable. The findings revealed that increased levels of occupational stress lead to increased levels of exhaustion and this may in turn lead to increased experience of somatic symptoms, anxiety and insomnia, social dysfunction and severe depression. Higher levels of exhaustion and cynicism were associated with higher levels of somatic symptoms, anxiety and insomnia, social dysfunction, and severe depression. The findings again revealed that an increase in the frequency of stress might lead to an increase in the experience of exhaustion, somatic symptoms, anxiety and insomnia, social dysfunction and severe depression. It was also found that stress could have some predictive value with regard to burnout, work engagement and health. It is recommended that more awareness need to be created about the symptoms and effects of occupational stress and burnout on individuals as well as organisations. This study was conducted in a small correctional institution, as a result the study population was too small, which made it difficult to generalise beyond the study population. / Thesis (M.A. (Industrial Psychology))--North-West University, Vaal Triangle Campus, 2006.

This thesis explores the experiences of individuals living in a family where a member is dying or has a life-threatening illness. It focuses in particular upon how families are actively produced in the everyday `doing' of day-to-day family life (Morgan, 1996) in circumstances of severe ill-health and when facing death. Using an ethnographic approach combining informal, in-depth interviews with 9 families and participant observation on a hospice ward, the research provides insight into how families experience themselves as family in the `here-and-now' of their daily lives. It will be argued that in both popular culture and theoretical work there is a pervasive tendency to associate death with crisis and that the more ordinary, everyday and mundane aspects of dying experiences are less well understood. Therefore, the analysis of family lives presented here moves away from the more familiar model of emotional crisis and rupture in relation to severe ill-health and dying, to ask new questions about the `everydayness' of people's feelings and experiences during this time. A more nuanced picture of living with life-threatening illness and dying is provided as the data chapters explore the everyday and mundane in relation to families' experiences. Analysing empirical data about various aspects of dayto- day life - including eating practices, spatial dynamics and material objects - the thesis shows how ill-health and dying are not discrete ontological experiences existing outside and separate from everyday life. Rather, in paying attention to the `doing' of being a family day-to-day, this research brings more squarely into view, the everyday as a lived experience (Felski, 1999) within which families come to `know' their experiences of illness and dying.

ABSTRACT Background: Morbidity patterns of patients attending general practices in Soweto, a suburban township south of Johannesburg, were studied using the international classification of primary care (ICPC) as a coding instrument. The ICPC was used to code reasons for encounter and diagnosis. One hundred and one private practices were in Soweto at the time of the survey and thirty-one of these practices were selected using random number tables to obtain as wide a distribution of geographical and socio economic groups as possible. Aim: The aim of this study is to determine the morbidity patterns of patients attending general practices in Soweto during a week in November of the summer of 1997; and a week in June of the winter of 1998. Objectives: 1) To determine demographic details of responding general practitioners in Soweto including sex, age and area of practice. 2) To determine socio-demographic features of patients attending practitioners in Soweto including age, sex, highest educational level, and occupation. Township of residence, housing details, namely number of rooms in residence, and number of persons living in residence. 3) To determine the initiator of the consultation, namely whether it was doctor initiated, patient initiated, or referred to the practitioner from another practitioner or clinic. IV 4) To determine factors related to the condition for which the patient consulted the doctor, including reason for encounter, diagnosis and whether the presenting problem was a new or an ongoing problem. 5) To determine the relationships between the above variables. Design: A prospective descriptive study design was employed in which doctors completed a survey questionnaire of all patients attended to in their practices during two weeks, one week in summer and one week in winter. Results: The 25 doctors in summer and the 20 doctors in winter, included in the survey described 4,432 encounters. These patients presented with 5,710 problems. Forty point three percent of patients (1780) were male and 59,7% patients (2,632) were female. Fifty two percent of patients (2306) were seen in summer and 48% (2,125) patients were seen in winter allowing the comparison of seasonal variation in morbidity patterns. The majority of patients were in the 20 to 50 year age group, followed by those under ten years of age. In all age groups, except children under the age of ten years, there were more encounters with females than males. In under ten year olds, male encounters were more than female encounters for all ages and twice as frequent as female encounters in the group under the age of one year. Most patients had a secondary education and lived in four roomed houses. Upper respiratory tract infections constituted, 16% (767) of the diagnoses and cough accounted for 16.1% (901) of all the reasons for encounter in all age groups especially in children below the age of 10 years. Digestive complaints were second most common reason for encounter and V diagnoses in the younger children especially in boys. Encounters and diagnoses associated with the eye, male genital system, female genital system, pregnancy and child bearing, ear, psychological, social and blood immune system disorders each accounted for less than 2% of the encounters experienced. Complaints of the musculoskeletal system were frequent in older patients. Family planning, vaginal discharge and painful urination occurred in the 10 to 50 year old age groups. As for encounters, diagnoses were age related with hypertension and osteoarthritis being the most common chronic disease afflicting patients over 30 years of age. Nineteen point seven percent (870) of the patients belonged to the trade and technical occupation, 13.6% (604) of the patients were children, 12.2% (539) of patients were unemployed, 9.6% (423) of patients were scholars, 9.4% (414) were professional, 8.6% (379) of patients were students, 8.1% (360) were pensioners and 7.6% (338) were office workers. Seven point three percent of the patients (325) were Labourers, and 3.9% (172) of the patients were housewives. Thirteen point seven percent of the patients (605) were from Meadowlands, 13% (577) from Dobsonville, 7.2% (318) from other areas outside Soweto, 6.7% (298) were from Orlando East, 6.6% (294) were from Zola and 6.1% (270) from Chiawelo. Less then 5% of the patients came from the remaining townships. Discussion: The present survey recorded encounters of 25 general practitioners in Summer and 20 general practitioners in Winter, with 4,432 patients and 5,710 VI problems. The week time period of the present survey is similar to that of Bourne et al. which determined the morbidity spectrum seen by a representative sample of 8% of the medical practitioners in South Africa in 1985. The sample size of the present study is considerably smaller than the comprehensive Cape Morbidity study, which was conducted over 1 year and recorded 49,347 diagnoses by 15 practitioners. This survey included 38,368 white patients and 14,979 patients of mixed racial origin but no blacks were included. The same limitation applies to the pilot survey conducted by Bloom et al in Cape Town between 1984 and 1988, where 13 practices recorded 64,959 encounters. Studies conducted outside South Africa are similar to those conducted within the country. This survey in comparison with other countries reflects consistency in the incidence of illness encountered by the family practitioner and also contemporary trends in morbidity seen in general practice. Most of the inhabitants of Soweto still make use of coal-stove fires and the town ship is usually enveloped in pall of heavy smoke coming from these coal stove fires. The main impression of Soweto is that of overcrowding and poverty, and still struggling in providing basic services including potable toilets to its poorer districts. Schools in Soweto remain largely without flushed toilets, furniture and electricity. Most of Soweto still has row upon row of so call matchbox houses crowded into unpaved dusty streets that are poorly lit. The above conditions explain the high reasons for encounter and diagnoses of respiratory and digestive conditions among the patients attending the private practices. This study shows that an enormous amount of everyday illness occurs in children and therefore education and advice for parents on how to cope with illness in their children remains important. VII Study Limitation: This survey was conducted in an impoverished township community where many people would attend clinics. It has selected encounters where the patients have the ability to pay for the services of a medical doctor. Conclusion: Few studies appear to be as comprehensive as this study where the reasons of encounter, the diagnosis, patient demographic and socio-economic data was recorded. This is also the largest survey conducted in an urbanized South African township. This survey has found a similar trend in the spectrum of disease, therefore providing a significant analysis of morbidity patterns encountered by the family practitioner in Soweto. There is an on going concern of the role of sexually transmitted diseases in the transmission of HIV, and this study has shown a significant burden of sexually transmitted disease in the asymptomatic population, particularly women in the age group 20 to 30 and 30 to 40 years. The overall burden of diseases in Soweto shows that respiratory problems are significant in all age groups. Chronic diseases such hypertension, osteoarthritis, presumed gastrointestinal infections, asthma and malignant neoplasm of the stomach as well as the anxiety disorders also featured prominently in the top 20 reasons for encounter and diagnoses. Information about mental health status in South Africa is scanty and has possibly led to an inadequate identification of a potential problem. This study has shown anxiety disorder/anxiety state as being a common reason for encounter and diagnoses in adults attending private practices in Soweto. To determine whether this survey reflects the morbidity patterns in this population as a whole would require additional data from the Government hospitals and clinics.

<p>För att få personalen på en arbetsplats att trivas och må bra bör en mängd faktorer tas i beaktande. Faktorer som beskrivs som viktiga är rolltydlighet och rollkonflikter, balans mellan krav och kontroll, upplevelsen av socialt stöd och balans mellan ansträngning och belöning. Då syftet med studien var att undersöka vilka psykosociala arbetsmiljöfaktorer som har ett samband med hälsan hos personal inom vård och omsorg användes en enkät som mätte alla ovanstående områden. Denna enkät kompletterades med frågor gällande kontakten med vårdtagarna. Enkätundersökningen (n = 80) följdes även upp av kvalitativa intervjuer (n = 4). Resultatet visade att de faktorer som starkast korrelerade med hälsa var hög upplevd kontroll, bra socialt stöd och bra kontakt med vårdtagarna.</p>

Thesis (M.A. (Industrial Psychology))--North-West University, Vaal Triangle Campus, 2006.